Katherine Deharte Botta, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MT228843 Issued in PA

Practice address

8815 Germantown Ave FL 5
Philadelphia, PA 19118-2722

Phone

(215) 248-8145

NPI assigned

Jun 8, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1245914480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 W PASTORIUS ST UNIT 17",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191443292",
            "telephone_number": "551-206-1514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8815 GERMANTOWN AVE FL 5",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191182722",
            "telephone_number": "215-248-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTA",
        "first_name": "KATHERINE",
        "middle_name": "DEHARTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-06-08",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT228843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Satonia Angel Boswell
• Tiffany Boswell, OD
• Jan P Boswinkel, M.D.
• Jessica Bosworth, RD, LDN
• Denise Botcheos
• Katelyn Bottcher
• Bryan Andrew Botti, M.D.
• Paul Devine Bottone, M.D.
• Alexander Botwick, D.M.D.
• Benchaa Boualam, MD

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.